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Organization
SMILE PHOENIX PLLC
Active
Organization
SMILE PHOENIX PLLC
Active
Other names
Smile Fitness Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS GORDON D.D.S (PRESIDENT)
(623) 362-8200
Entity
Organization
Contact information
Practice address
2330 N 75TH AVE STE 112, PHOENIX, AZ 85035-1200
(623) 849-0477
(623) 849-6111
Mailing address
2330 N 75TH AVE STE 112, PHOENIX, AZ 85035-1200
(623) 849-0477
(623) 849-6111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2191
AZ
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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